Steroid plus antiviral treatment for Bell's palsy

Abstract

Abstract. Kang HM, Jung SY, Byun JY, Park MS, Yeo SG (Kyung Hee University, Seoul, Korea). Steroid plus antiviral treatment for Bell's palsy. J Intern Med 2015; 277: 532-539.Objectives. The effectiveness of antiviral agents for the treatment of Bell's palsy is uncertain. We evaluated whether a steroid with an antiviral agent (S + A group) provided better recovery outcomes than a steroid alone (S group) in patients with Bell's palsy.Subjects and design. A total of 1342 patients diagnosed with Bell's palsy who visited the Kyung Hee Medical Center in Seoul, Korea, from 2002 to 2012 were included in this study. Patients in the S + A group were treated with prednisolone and antiviral agents (n = 569) and those in the S group with prednisolone alone (n = 773). Outcomes were measured using the House-Brackmann (HB) scale according to age, initial disease severity, electroneurography (ENoG) findings and underlying comorbidities.Results. The rate of recovery (HB grades I and II) with initially severe Bell's palsy (HB grades V and VI) was higher in the S + A than in the S group (P = 0.001). However, the rates of recovery were similar with initially moderate palsy (HB grades II-IV) (P = 0.502). In patients classified according to age and ENoG-determined severity of palsy, the overall recovery rate was higher in the S + A than in the S group, but the differences were not statistically significant (P > 0.05 for both). The recovery rate without diabetes mellitus (DM) and hypertension (HTN) was higher in the S + A group than in the S group (P = 0.031). But in the patients with HTN and DM, the difference in recovery rates between the S + A and S groups was not statistically significant (P = 0.805).Conclusions. Treatment with a steroid plus antiviral agent resulted in significantly higher recovery rates than steroid therapy alone in patients with initially severe Bell's palsy and without either HTN or DM, and a nonsignificant trend towards higher recovery rates in all patients with Bell's palsy in this study. Antiviral agents may therefore help in the treatment of Bell's palsy.

Facial nerve paralysis grade V managed with combined medical and alternative therapy: a case report with literature review

“…The literature so far has been presenting very contradictory results. [13][14][15][16] Ocular protection has to be emphasised to prevent lesions of the cornea and conjunctiva, which are very frequent in these cases.…”

“…Some studies have sought to use antiviral agents, corticoids, rehabilitation and even surgical decompression of the nerve in search of some significant result. The literature so far has been presenting very contradictory results . Ocular protection has to be emphasised to prevent lesions of the cornea and conjunctiva, which are very frequent in these cases.…”

A study of affecting the recovery of Chinese patients with Bell palsy

“…Some studies and guidelines were recommended that combined treatment maybe a good choice. [26,27] Our study showed that the use of steroids plus antivirals and the use of steroids plus mecobalamin are 2 good choices.…”

The Efficacy of Low-Level Laser Therapy in the Treatment of Bell’s Palsy in Diabetic Patients

“…Various types of therapeutic approaches are available, but the effectiveness of definitive treatments are unknown. 17 The traditional systemic corticosteroid therapy in acute peripheral Bell's palsy in patients with DM type 2 can cause hyperglycemia, and local therapy is required as an alternative treatment approach. 18,19 Palsy could be treated by corticosteroids up to the rate of 17% in a complete recovery by treatment difference.…”